Medical researchers have long debated on whether drug addiction is a voluntary or an involuntary act. But what they seem to unanimously agree on is that it has a biological basis. It may or may not be compulsive though. The deemed question now hence becomes, the factors that enable addiction and the act of quitting the same. In the case of self-quitting due to external factors such as societal and economic pressure, the act qualifies as a choice. On the other hand, addiction itself, is a persistent destructive pattern that is identified as a chronic disease.
The Kolmac Outpatient Recovery Center states undisputedly that the disease mode of addiction starts as a choice. But once the body is introduced to a new substance, a dynamic complexity of the brain leads to a dependency on the substance which dictates behavioural patterns including the choices one makes, resulting in a long-term disease. Ironically, the substance eliminates one’s capacity to make any further choices.
It is however essential to first discuss, why the addiction begins- is it really a choice? The National Institute on Drug Abuse has found that children who are the most vulnerable to drug addiction fall into the trap either because they have to work with them owing to their socioeconomic conditions or are genetically trapped into the vicious cycle. Like many other diseases, hence, addiction is also both genetically factored and socio-culturally influenced- which may or may not be one’s options to choose from. It is a disorder, and not beneficial in the long run.
Addiction caused by addictive substances such as drugs and alcohol have enough evidence to prove that like in any other disease they also tamper with bodily functions and have permanent repercussions. Excessive drug intake causes a rise in the dopamine levels, that dominates the brain’s pleasure centre, enabling neurotransmitters dictate the continual seeking of the substance, which seems like a choice one is making. The truth being, in the long run, the overwhelmed brain falters to function without the dopamine rise, often shutting down. Overtime, the drug impacts the systems responsible for memory, motivation, and learning. To restart these processes the individual repeats the addictive substance to release the same chemicals associated with pleasure. This is where the compulsion to intake the drug comes in leading to a permanent change in the neurotic system, causing relapses and difficulty in quitting. Deciding to quit is however a tough ‘choice’ that one makes.
Though addiction affects the choices that the brain makes, it does not take away the ability to distinguish between harmful and non-harmful actions for self. An individual has full responsibility for making the choice to consume a drug at first, but the changes that the drug brings to the nervous system of a person makes it difficult to get rid of it easily. For those questioning the lack of willpower while quitting, the substance manages to impair the control over self. Added are post quitting disorders of anxiety and depression, which can result in more susceptible reasons of why quitting is not a choice, but a medical procedure that requires enough post-monitoring and support even in the recovery process.
The dilemma can be understood in a simpler way by distinguishing the quantitative and qualitative reasons. Viewing addiction as a choice can be seen a pattern of uncalculated decisions whereas recognizing it as a disease means factoring the reasons and circumstances that have led to this destructive habit. While undoubtedly, we are a result of our own choices and drug addiction is an outcome of multi-plural factors, many of which can be avoided, it is essential to understand the qualitative factors, that often outweigh the quantitative reasonings.
Just like asthma, diabetes, and cancer, which can only be avoided by maintaining a healthy lifestyle, addiction can also be partially avoided. But even in cases of mild substance disorder, the recognition of the problem and professional help and advice is required to eliminate it. Moreover, qualifying drug addiction as a disease is sought to be a way of normalising to seek medical health and care for it like any other disease. Endorsement of drug addiction as a disease helps considering that there are social economic factors that cannot be controlled, but one’s health can be. Along with medical facilities, the recognition of addiction also provides will-power and de-stigmatizes, providing social acceptance to those ailing and recovering from it. Drug addiction is a curable disease and needs awareness to make recovery accessible to all and prevent those who are vulnerable and most likely to become prone to it.
• Miller, Roxanne Greitz. “Advancing Understanding of Drug Addiction and Treatment.” Science Scope, vol. 32, no. 6, 2009, pp. 14–17. JSTOR, www.jstor.org/stable/43183825. Accessed 6 July 2021.
• Heyman, G. M. (2013). Addiction and choice: theory and new data. Frontiers in psychiatry.https://doi.org/10.3389/fpsyt.2013.00031